Research Progress of Prevention and Control of Deep Vein Thrombosis Embolism

It is not well understood the efficacy and safety of primary deep vein thrombosis (DVT) prophylaxis of anticoagulants in patients with solid tumors. This systematic review and meta-analysis of randomized controlled trials (RCT) determines the relative ratio of primary DVT, survival rate and bleeding events among patients with solid tumors treated with anticoagulants or placebo. Comprehensive literature searches were conducted through the Pubmed, Ovid MEDLINE and EMBASE databases published from January 1st, 1993 to December 31st, 2015. Statistical analysis was performed by RevMan 5.0 software. For DVT events, therisk ratio in 16 trials between the prophylactic and control patients was statistically significant at 0.45 [0.36-0.58]; for major bleeding events, the risk ratio in 18 trials between the prophylactic and control patients was not statistically significant at 1.33 [0.99-1.79], while that in 15 trials with clinically relevant non-major bleeding was statistically significant at 1.83 [1.46-2.30]; the risk ratio for the mortality rate of patients with solid tumors in 16 trials was not statistically significant at 0.97 [0.93-1.02]. Inconclusion, the risk ratio in this meta-analysis showed a significantly reduced incidence of DVT with anticoagulant use. Treatment to patients who had solid tumors with prophylactic anticoagulants enhanced the incidence rate of non-major bleeding but has no significant impact on the incidence rate of major bleeding. No significant differences were found in the mortality outcomes between anticoagulant and non-anticoagulant groups.

Concomitant Use of Diosmin/Hesperidin and Oral Rivaroxaban Increases Deep Vein Recanalization and Reduces the Incidence of Post-Thrombotic Syndrome in Patients with Proximal Deep Vein Thrombosis

Blood ◽

10.1182/blood-2018-99-110084 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 986-986

Author(s):

Kirill Lobastov ◽

Iliya Schastlivtsev ◽

Victor Barinov

Keyword(s):

Deep Vein Thrombosis ◽

Clinical Severity ◽

Proximal Deep Vein Thrombosis ◽

Control Groups ◽

Vein Thrombosis ◽

Post Thrombotic Syndrome ◽

And Control ◽

Deep Vein ◽

The Impact

Abstract Aim: To assess the impact of long-term Diosmin/Hesperidin use in the treatment of proximal deep vein thrombosis (DVT). Methods: This study was a pilot randomized open-label study with blinded outcome assessor - enrolled patients with their first episodes of popliteal-femoral DVT confirmed by duplex ultrasound (DUS). All participants were randomized into two groups: 1.) control that received a standard treatment with oral Rivaroxaban, and 2.) experimental that required additional treatment with Diosmin/Hesperidin 450/50 mg twice a day. Both drugs were used for six months. Patients were followed-up for the whole treatment period with series DUS every two months in order to evaluate the degree of recanalization by popliteal (PV), superficial femoral (SFV), and common femoral (CFV) veins' compressibility. Thrombi extension was assessed by modified Marder score. At the end of the follow-up period, patients were assessed with Villalta and venous clinical severity scores. Post-thrombotic syndrome (PTS) was diagnosed in those who had ≥5 Villalta score. Results: Sixty patients were randomized to the control and experimental groups (n=30 in each group). There were 40 men and 20 women with mean age of 56.3±13.4. Clinically unprovoked DVT was recognized in 65% of cases and left side localization in 45%. The median of Marder baseline scores were 15.0±4.8 and 11.1±4.3 in the experimental and control groups, respectively (p=0.002). After six months of treatment, the Marder score decreased to 0.8±1.6 and 2.8±3.5 in the main control groups, respectively (p=0.006). The generalized linear model repeated measures found a greater reduction in the Marder score (р <0.0001) and increased speed of recanalization on SFV (р <0.0001) with a non-significant tendency in the CFV (p=0.130) and PV (p=0.204) in the experimental group compared to the control one. Full recanalization of the PV at six months was observed in 24 patients (80%), who had received Diosmin/Hesperidin, and only in 17 persons (57%) of the control group (p=0.047). The median of Villalta score in the group treated with Diosmin/Hesperidin was significantly lower compared to the control one (2.9±2.7 versus 5.8±3.0 [p <0.0001]). The same difference was found for VCSS score (2.3±1.9 versus 4.9±1.9 [p <0001]). According to the Villalta score, PTS was recognized in six patients (20%) and 17 patients (57%) in the experimental and control groups, respectively (p=0.004). Conclusion: Long-term treatment with Diosmin/Hesperidin can increase the speed of deep vein recanalization and reduce the incidence of PTS diagnosed at six months in patients with proximal DVT treated with oral rivaroxaban. Disclosures Lobastov: Bayer: Honoraria, Speakers Bureau; Servier: Honoraria, Speakers Bureau. Schastlivtsev:Bayer: Honoraria, Speakers Bureau; Servier: Honoraria, Speakers Bureau. Barinov:Bayer: Honoraria, Speakers Bureau; Servier: Honoraria, Speakers Bureau.

Anticoagulation Treatment for Patients with Coronavirus disease 2019 (COVID-19) and its clinical effectiveness in 2020: A meta-analysis study

10.21203/rs.3.rs-551086/v1 ◽

2021 ◽

Author(s):

Jingyi Ge ◽

Yingmin Ma ◽

Zhipeng Wu ◽

Jiawei Jin ◽

Xiao Sun

Keyword(s):

Deep Vein Thrombosis ◽

Lower Risk ◽

Cochrane Library ◽

Vein Thrombosis ◽

Therapeutic Anticoagulation ◽

Significant Difference ◽

Current Outbreak ◽

Prophylactic Anticoagulation ◽

And Control ◽

Deep Vein

Abstract Objective To better inform efforts to treat and control the current outbreak with effective anticoagulant treatment strategies for coronavirus disease 2019 (Covid-19) patients. Methods We searched Cochrane Library, Pubmed, EMBASE, MEDLINE, SCIEXPANDED, Web of Science, Google Scholar, CNKI (Chinese Database), WanFang (Chinese Database), CBM (Chinese Database), VIP (Chinese Database) for studies published from November 1st 2019 to October 1, 2020, and we searched references of identified articles. Studies were reviewed for methodological quality. A random-effects model was used to pool results. Heterogeneity was assessed using I2. Publication bias was assessed using funnel plot. Results Fourteen studies involving 7,681 patients were included. We meta-analyzed the bleeding, deep vein thrombosis and pulmonary embolism risk between no anticoagulation and prophylactic anticoagulation, and found no significant difference. The same trend occurred in the comparison between with and without anticoagulation. However, when compared with no anticoagulation, both prophylactic anticoagulation (OR = 0.80, 95%CI: 0.69–0.93) and therapeutic anticoagulation (OR = 0.91, 95%CI: 0.80–1.05) had lower risk of mortality. Furthermore, the risk of overall bleeding among patients with therapeutic anticoagulation was 3.11 times (95% CI: 2.29–4.24) than that of patients with prophylactic anticoagulation, on the contrary, therapeutic anticoagulation had lower risk of deep vein thrombosis than prophylactic anticoagulation (OR = 0.34, 95%CI: 0.19–0.63). Conclusions Among Covid-19 patients, preventive and therapeutic anticoagulation were more beneficial than no anticoagulation for reducing mortality risk. The result will inform healthcare providers and public health policy makers in their efforts to treat and control the current outbreak.

Influence of Prescribed Blood Products on the Incidence of Deep Vein Thrombosis and Pulmonary Embolism in Surgical Patients

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/1076029616689301 ◽

2017 ◽

Vol 23 (8) ◽

pp. 938-942

Author(s):

Alenka Premuš Marušič ◽

Igor Locatelli ◽

Aleš Mrhar ◽

Martin Caprnda ◽

Ludovit Gaspar ◽

...

Keyword(s):

Deep Vein Thrombosis ◽

Red Blood Cells ◽

Blood Cells ◽

Surgical Patients ◽

Blood Products ◽

Control Groups ◽

Packed Red Blood Cells ◽

Vein Thrombosis ◽

And Control ◽

Deep Vein

Deep vein thrombosis (DVT) and pulmonary embolisms (PEs) are common complications after surgical procedures. The influence of prescribed blood products on the occurrence of DVT and PE was evaluated in postsurgical patients in this retrospective case–control study. The records of 286 surgical patients were analyzed: DVT (n = 52), PE (n = 92), and a control group (n = 142). The amounts of prescribed blood, blood products, and vitamin K were reviewed, together with appropriate prescribing of low-molecular-weight heparins. The influence of prescribed blood products on the occurrence of DVT or PE was analyzed using multinomial logistic regression. We demonstrated a significant difference between the test and control groups ( P < .05) in relation to receiving packed red blood cells. Treatment with red blood cells was associated with an increased risk of PE but not DVT. Patients who developed PE after surgery were hospitalized for longer (median 10 days) than patients with DVT (median 6 days). There was no difference between the test and control groups concerning treatment with fresh frozen plasma. Inadequate thromboprophylaxis significantly increased the likelihood of DVT. There is a connection between receiving packed red blood cells and occurrence of postoperative PE in surgical patients. Thus, patients receiving red blood cells should be monitored more closely after surgery, as they are more likely to develop PE postoperatively.

Research Progress of Nursing Care for Elderly Patients With Complicating Postoperative Hip Fracture Deep Vein Thrombosis in China

International Journal of Studies in Nursing ◽

10.20849/ijsn.v6i4.948 ◽

2021 ◽

Vol 6 (4) ◽

pp. 81

Author(s):

Dandan Zheng ◽

Wentao Cheng ◽

Heyu Wu ◽

Haichao Wu ◽

Yuqi Cao

Keyword(s):

Deep Vein Thrombosis ◽

Hip Fracture ◽

High Risk ◽

Elderly Patients ◽

The Elderly ◽

Nursing Intervention ◽

Psychological State ◽

Research Progress ◽

Vein Thrombosis ◽

Deep Vein

Introduction: The aging of China's population has further deepened, and according to the results of the seventh national census, the population aged 60 years and above in China was 264.02 million, accounting for 18.70% (China.2021).The rapid growth of the elderly population has led to an increase a geriatric orthopedic morbidity. The hip fracture is one of the common orthopedic diseases, which has posed a severe threat to the elderly's life and health (Yu, 2019).Purpose: In this study, we investigated the domestic and international literature, focusing on the analysis of DVT nursing prevention programs for elderly patients after hip arthroplasty, and proposed the current nursing research progress in preventing DVT to help elderly patients actively cope with DVT, improve the quality of life in later life, and make DVT a truly preventable disease.Method: Electronic searches using scholarly databases were employed and only significant articles that met the review objective were utilized.Findings: Currently, the main treatment option for hip fracture patients in clinical practice is surgery, and how to prevent Deep Vein Thrombosis (DVT) is an important task in the postoperative care of elderly orthopedic patients (Li, 2016). Research studies have shown that all elderly patients are at a very high risk of DVT during hospitalization, but the current trend is that 50% of patients at high risk of thrombosis are still not actively and effectively prevented from developing thrombosis for various reasons.Conclusion: This disease, which has a high incidence, a high mortality rate, and is difficult to prevent, requires increased attention and necessitates exploration to derive effective nursing intervention programs and related nursing measures to prevent reduce the formation of DVT and alleviate suffering for patient (Xu, 2016).In this review, we summarized the main nursing methods for preventing deep vein thrombosis of the lower extremities after hip fracture surgery in the elderly. Elderly patients are a special group of people, both physically and psychologically in a relatively fragile state, especially after the operation, so they need to be more careful in nursing work. In addition to general physical care, the care of their psychological state is also extremely important. This article describes in detail the physiological and psychological nursing interventions for patients, which can effectively guide and help medical staff to cope with the clinical care of such patients, and enable patients to better recover from surgery and trauma, and obtain a good prognosis.

Systematic Underestimation of Treatment Effects as a Result of Diagnostic Test Inaccuracy: Implications for the Interpretation and Design of Thromboprophylaxis Trials

Thrombosis and Haemostasis ◽

10.1055/s-0038-1653746 ◽

1995 ◽

Vol 73 (02) ◽

pp. 167-171 ◽

Cited By ~ 40

Author(s):

Anthony Rodgers ◽

Stephen MacMahon

Keyword(s):

Deep Vein Thrombosis ◽

Diagnostic Test ◽

Diagnostic Tests ◽

Treatment Effects ◽

Screening Tests ◽

Randomised Trials ◽

Control Groups ◽

Vein Thrombosis ◽

And Control ◽

Deep Vein

SummaryMany clinical trials that have assessed strategies for the prevention of deep vein thrombosis have employed diagnostic tests that are less accurate than venography. The correct interpretation of these trials has been the subject of considerable debate. This paper attempts to quantify the likely effects of the use of inaccurate diagnostic tests (in particular fibrinogen scanning) on the validity and precision of estimates of treatment effects. It is shown that, if there is no difference in the rate of misclassification of deep vein thrombosis between study and control groups, then treatment effects will tend to be systematically underestimated in trials that only use inaccurate diagnostic tests. However, for trials in which there are no false positive diagnoses, such as those employing venography, the estimate of relative treatment effects will be unbiased. This phenomenon is demonstrated empirically by data from randomised trials of antiplatelet therapy. The implications of these findings are two-fold. First, so long as the accuracy of the test is the same in study and control groups, positive trial results cannot be ascribed to diagnostic test inaccuracy. Second, unbiased estimates of relative treatment effects can be obtained by using cheap, practicable and non-invasive screening tests that are supplemented by venographic assessment of positive test results. This would facilitate the conduct of much larger randomised trials than has generally been possible when mandatory venography was used; if future trials randomised some thousands of patients and employed confirmatory venography then they would provide both unbiased and precise estimates of relative treatment effects.

Prevention of Pulmonary Embolism by Inferior Vena Cava Filter in Patients With Proximal Deep Vein Thrombosis

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(97)85281-3 ◽

1998 ◽

Vol 31 (2) ◽

pp. 362A

Author(s):

R Faivre

Keyword(s):

Pulmonary Embolism ◽

Deep Vein Thrombosis ◽

Inferior Vena Cava ◽

Inferior Vena Cava Filter ◽

Inferior Vena ◽

Vena Cava ◽

Vena Cava Filter ◽

Proximal Deep Vein Thrombosis ◽

Vein Thrombosis ◽

Deep Vein

Incidence of Deep Vein Thrombosis After Varicose Vein Surgery

Yearbook of Vascular Surgery ◽

10.1016/s0749-4041(08)70279-3 ◽

2006 ◽

Vol 2006 ◽

pp. 363-364

Author(s):

G.L. Moneta

Keyword(s):

Deep Vein Thrombosis ◽

Varicose Vein ◽

Varicose Vein Surgery ◽

Vein Thrombosis ◽

Deep Vein

Feasibility Study of Catheter-directed Thrombolysis with Recombinant Staphylokinase in Deep Venous Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614936 ◽

1998 ◽

Vol 79 (03) ◽

pp. 517-519 ◽

Cited By ~ 13

Author(s):

Stephane Heymans ◽

Raymond Verhaeghe ◽

Luc Stockx ◽

Désiré Collen

Keyword(s):

Deep Vein Thrombosis ◽

Continuous Infusion ◽

High Speed ◽

Minor Bleeding ◽

Vein Thrombosis ◽

Catheter Directed Thrombolysis ◽

Long Term Follow Up ◽

Valve Function ◽

Rotating Impeller ◽

Deep Vein

SummaryThe feasibility of catheter-directed thrombolysis with recombinant staphylokinase was evaluated in six selected patients with deep vein thrombosis. The patients underwent intrathrombus infusion of recombinant staphylokinase (2 mg bolus followed by a continuous infusion of 1 mg/h). Heparin was given via the catheter as a bolus (5000 U) and as a continuous infusion (1000 U/h). Complete lyis was obtained in five patients and partial lysis in one patient. Complications consisted of minor bleeding in four subjects. Symptomatic reocclusion occurred in one. Debulking of the thrombus mass by a high speed rotating impeller (n = 1) and stenting (n = 3) were used as additional interventions. An underlying anatomical abnormality was present in two patients. Long term follow up revealed normal patency in all patients and normal valve function in four patients. Symptomatic venous insufficiency with valve dysfunction was present in the two with a second thrombotic episode.Thus catheter-directed infusion of recombinant staphylokinase in patients with deep vein thrombosis appears feasible and may be associated with a high frequency of thrombolysis. Larger studies to define the clinical benefit of this treatment appear to be warranted.